The art and science of non

This essay considers some limitations of programme theory evaluation in relation to healthcare policies. This approach, which seeks to surface ‘programme theories’ or construct ‘logic models’, is often unable to account for empirical observations of policy implementation in real-world contexts. I argue that this failure stems from insufficient theoretical elaboration of the social, cultural and political dimensions of healthcare policies. Drawing from institutional theory, critical theory and discourse theory, I set out an alternative agenda for policy research. I illustrate the issues with respect to programme theory evaluation with examples from my experience of research on large-scale strategic change in the English NHS